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Colorado adults ace health rankings

Colorado adults can be proud of their scores on the 2011 Colorado Health Report Card.

Their children have less to boast about.

The Centennial State ranked first in the nation last year for lowest portion of obese adults and highest portion of older adults who received a flu shot and a pneumonia vaccination. Nearly 59 percent of older Coloradans received flu and pneumonia vaccinations in 2011, and 22 percent of all adults in the state were considered obese, according to the sixth annual Colorado Health Report Card, released this week by the Colorado Health Foundation. The report card gives Colorado age groups a grade based on how they rank among the 50 states in various health-related categories.

While adults and older adults in Colorado got B grades in the most recent report card, the state’s babies, children, and adolescents received grades of C, C-minus and B-minus, respectively.

Colorado ranked 20th in the nation for percentage of children who live in families with incomes below the federal poverty level, with 81.7 percent of children living in families that earned an income at or above that line. Twentieth was the highest ranking Colorado’s children earned among six health indicators. The state ranked 38th for children who received preventative dental care at 77 percent and 36th for children not covered by health insurance at 9.3 percent.

Although the state’s adolescents scored well for eating lots of fruits and vegetables and had the nation’s lowest percentage of sexually active teens at 27.4 percent, Colorado’s adolescents were some of the least-insured teens and preteens in the nation. Ten percent of Colorado adolescents were insured in 2011, ranking 29th in the U.S. Colorado also ranked 29th for its teen fertility rate of 42.5 births to every 1,000 female teens. Both of those rankings are cause for concern, according to Hilltop Director of Child and Family Services Jackie Sievers. Sievers said she was particularly disturbed by the state’s low health insurance ranking because enrollment criteria have expanded for programs that Hilltop helps children and pregnant women enroll in, including CHP+ and Medicaid.

“A family of four can earn up to $4,803 a month and qualify for CHP+. More families than ever qualify, so we would love to see that number go up,” she said, referring to the percentage of insured children and teens.

At 18.3 percent, Colorado ranks 24th in percentage of working-age adults who are not covered by health insurance. Less than 6 percent of older Coloradans say they don’t have a primary caregiver, but that ranks 36th in the U.S. The percentage increases to 21.6 percent among working-age adults, which is 28th in the nation.

Those two trends can correlate, according to Dr. Michael Pramenko of Primary Care Partners. Pramenko said the insured are more likely to have a primary doctor, but the price of insurance is increasing faster than inflation in Colorado. Not having it can be pricey, too.

“If you don’t have a primary caregiver, it’s a little more difficult to navigate the health care system, and you probably end up spending more money. Going to a clinic is much less expensive than going to the emergency room,” Pramenko said.

Steve Hurd, director of Marillac Clinic, which offers health care to uninsured Mesa County residents, said he is not surprised by Colorado’s low portion of residents with a primary physician. Patients who visit the clinic usually see the same physician visit after visit, but the team approach at the clinic does not ensure that always happens, especially if someone needs emergency care.

Hurd said primary care physicians are retiring, and not enough are being replaced by new medical school graduates, because they can make more money as specialists, who are reimbursed by insurance companies per procedure.

“The reimbursement system has to change to a value-based reimbursement,” Hurd said. “The more primary care a person has, the less likely they are to develop chronic conditions.”

The bragging rights for adults come in other categories, such as percentage of adults diagnosed with high blood pressure or diabetes. Colorado had the second and third fewest, respectively, in those categories. The state ranked fifth in adults who participated in any physical activity in the last month, 83 percent, and had the nation’s fourth-most active senior citizen population, with three-fourths of older Coloradans saying they participated in physical activities at least once in the past month.

The state ranked high for having small portions of older citizens who had poor physical or mental health.

Colorado had the fifth-lowest percentage of pregnant mothers who smoke during the third trimester of pregnancy, 8.1 percent, and the country’s 12th-lowest infant mortality rate, with 6.1 deaths for every 1,000 live births. The state’s grade for babies and prenatal care was weighed down, however, by a low ranking for percentage of preschool-age children who got all doses of five key vaccines (71.3 percent) and percentage of babies born weighing less than 5 pounds, 9 ounces (8.9 percent).

Sievers said Colorado may have a passing grade for mothers who quit smoking during pregnancy, but Mesa County has catching up to do. She said Hilltop’s B4 Babies program is trying to help with a smoking-cessation program for expectant moms. In 2011, 11 percent of women who participated in B4 Babies smoked during pregnancy, while 19 percent of pregnant Mesa County women who did not participate in the program smoked during pregnancy.